BEULAH JYOTHY KODURU Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036147358

License Status

NOT RENEWED

Business

First Name

BEULAH

Middle

JYOTHY

Last Name

KODURU

Business Name

BEULAH JYOTHY KODURU

Original Issue Date

08/28/2018

Effective Date

08/28/2018

Expiration Date

09/30/2020

City

CHAMPAIGN

State

Zip

61822

Ever Disciplined

LastModifiedDate

01/14/2021